Provider Demographics
NPI:1275357832
Name:PEARCE, AMBER (ACMHC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:PEARCE
Suffix:
Gender:F
Credentials:ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13694 S HACKAMORE CIR
Mailing Address - Street 2:
Mailing Address - City:DRAPER
Mailing Address - State:UT
Mailing Address - Zip Code:84020-8518
Mailing Address - Country:US
Mailing Address - Phone:801-573-9315
Mailing Address - Fax:385-900-4561
Practice Address - Street 1:11576 S STATE ST STE 1001
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-7107
Practice Address - Country:US
Practice Address - Phone:801-573-9315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12480192-6009101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health